Provider Demographics
NPI:1033362520
Name:MICHALS, PATRICIA KELLY (MFT, LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:KELLY
Last Name:MICHALS
Suffix:
Gender:F
Credentials:MFT, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 VIA DE LA VALLE
Mailing Address - Street 2:SUITE 113 E
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-4247
Mailing Address - Country:US
Mailing Address - Phone:858-755-5687
Mailing Address - Fax:858-792-6384
Practice Address - Street 1:3790 VIA DE LA VALLE
Practice Address - Street 2:SUITE 113 E
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4247
Practice Address - Country:US
Practice Address - Phone:858-755-5687
Practice Address - Fax:858-792-6384
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34381041C0700X
CA5362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist